Chapter 18 - Body Fluid Analysis in the Hematology Laboratory Flashcards
Refer to the following scenario to answer questions 1 and 2: A spinal fluid specimen is diluted 1:2 with Türk solution to perform the nucleated cell count. A total of 6 nucleated cells are counted on both sides of the hemacytometer, with all nine squares
counted on both sides. Undiluted fluid is used to perform the RBC count. A total of 105 RBCs is counted on both sides of the hemacytometer, with four large squares on both sides counted.
- The nucleated cell count is ___/mL.
b. 7
Refer to the following scenario to answer questions 1 and 2: A spinal fluid specimen is diluted 1:2 with Türk solution to perform the nucleated cell count. A total of 6 nucleated cells are counted on both sides of the hemacytometer, with all nine squares
counted on both sides. Undiluted fluid is used to perform the RBC count. A total of 105 RBCs is counted on both sides of the hemacytometer, with four large squares on both sides counted.
The RBC count is ___/mL.
a. 131
Based on the cell counts, the appearance of the fluid is:
c. Clear
All of the following cells are normally seen in CSF, serous fluids, and synovial fluids except:
b. Neutrophils
Spinal fluid was obtained from a 56-year-old woman. On
receipt in the laboratory, the fluid was noted to be slightly bloody. When a portion of the fluid was centrifuged, the supernatant was clear. The cell counts were 5200 RBCs/mL3 and 24 WBCs/mL. On the cytocentrifuge preparation,
several nucleated RBCs were seen. The differential was 52% lymphocytes, 20% neutrophils, 22% monocytes, 4% myelocytes, and 2% blasts. What is the most likely explanation for these results?
a. Bone marrow contamination
A 34-year-old woman with a history of breast cancer developed a pleural effusion. The fluid obtained was bloody and had a nucleated cell count of 284/mL. On the cytocentrifuge preparation, there were several neutrophils and a few monocytes/histiocytes. There were also several clusters of large, dark-staining cells. These cell clumps appeared
“three-dimensional” and contained some mitotic figures.
What is the most likely identification of the cells in clusters?
b. Metastatic tumor cells
A serous fluid with a clear appearance, specific gravity of 1.010, protein concentration of 1.5 g/dL, and fewer than 500 mononuclear cells/mL would be considered:
c. A transudate
On the cytocentrifuge slide prepared from a peritoneal fluid sample, many large cells are seen, singly and in clumps. The cells have a “fried egg” appearance and basophilic cytoplasm, and some are multinucleated. These cells should be reported as:
d. Mesothelial cells
Refer to the following scenario to answer questions 9 and 10: A 56-year old man came to the physician’s office with complaints of pain and swelling in his left big toe. Fluid aspirated from the toe was straw-colored and cloudy. The WBC count was 2543/mL. The differential consisted mainly of neutrophils and monocytes/histiocytes. Intracellular and extracellular crystals were seen on the cytocentrifuge slide. The crystals were needle-shaped and, when polarized with the use of the red compensator, appeared yellow on the y-axis.
The crystals are:
c. Monosodium urate
Refer to the following scenario to answer questions 9 and 10: A 56-year old man came to the physician’s office with complaints of pain and swelling in his left big toe. Fluid aspirated from the toe was straw-colored and cloudy. The WBC count was 2543/mL. The differential consisted mainly of neutrophils and monocytes/histiocytes. Intracellular and extracellular crystals were seen on the cytocentrifuge slide. The crystals were needle-shaped and, when polarized with the use of the red compensator, appeared yellow on the y-axis.
This patient’s painful toe was caused by:
a. Gout
